• Tomoaki Suzuki, Hitoshi Hasegawa, Kouichirou Okamoto, Kohei Shibuya, Haruhiko Takahashi, Hidemoto Fujiwara, Makoto Oishi, and Yukihiko Fujii.
• Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan. Electronic address: t.suzuki2078@gmail.com.
• World Neurosurg. 2023 Jul 1; 175: e1292e1299e1292-e1299.

ObjectiveThe evaluation of postsurgical neoangiogenesis in patients with moyamoya disease (MMD) is crucial for appropriate patient management. This study aimed to assess the visualization of neovascularization after bypass surgery using noncontrast-enhanced silent magnetic resonance angiography (MRA) with ultrashort echo time and arterial spin labeling.MethodsAfter bypass surgery, 13 patients with MMD were followed up for >6 months between September 2019 and November 2022. They underwent silent MRA in the same session as time-of-flight magnetic resonance angiography (TOF-MRA) and digital subtraction angiography (DSA). Two observers independently rated the visualization of neovascularization in both types of MRA from 1 (not visible) to 4 (nearly equal to DSA), with reference to DSA images as the standard.ResultsThe mean scores were significantly higher for silent MRA compared with TOF-MRA (3.81 ± 0.48 and 1.92 ± 0.70, respectively) (P < 0.01). The intermodality agreements were 0.83 and 0.71 for silent MRA and TOF-MRA, respectively. TOF-MRA depicted the donor artery and recipient cortical artery after direct bypass surgery, although fine neovascularization developed after indirect bypass surgery was poorly visualized. Silent MRA could reveal the developed bypass flow signal and perfused middle cerebral artery territory, which was almost equal to the DSA images.ConclusionsSilent MRA achieves better visualization of postsurgical revascularization in patients with MMD than TOF-MRA. Moreover, it may have the potential to provide visualization of the developed bypass flow equivalent to DSA.Copyright © 2023 Elsevier Inc. All rights reserved.

14 keywords...

hide…